| NPI | 1295394104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 12368983) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-18-50390) |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2024-07-19 |